Grant Application
Application Type
*
Residential
Business
Name
*
First Name
Last Name
Business Name
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Website Address
Date of Birth
*
-
Month
-
Day
Year
Date
Percent of Ownership
*
Business Type/Industry
Date Established
-
Month
-
Day
Year
Date
Number of Employees
Please Select
1-5
6-10
11-25
26-50
51+
Annual Revenue
Please Select
Less than $50K
$50K-$100K
$100K-$500K
$500K+
Brief Description of Your Business
*
How Will You Use the Grant?
*
300-500 words
What Impact Will This Grant Have on Your Business?
*
(300-500 words)
Upload Business Plan
Browse Files
Drag and drop files here
Choose a file
Email summary to info@directinc.biz
Cancel
of
Upload Financial Statements
*
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Choose a file
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of
Upload Proof of Business Registration
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Drag and drop files here
Choose a file
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of
How Did You Hear About Us?
*
Please Select
Social Media
Search Engine
Referral
Other
I certify that the information provided in this application is accurate and complete to the best of my knowledge.
*
Yes
No
I agree to the terms and conditions of this Small Business Grant Program.
*
Yes
No
Signature
*
Submit
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